The Female Pelvic Floor

Function, Dysfunction and Management According to the Integral Theory

  • Peter Petros

Table of contents

  1. Front Matter
    Pages I-XXII
  2. Peter Petros
    Pages 1-13
  3. Peter Petros
    Pages 48-76
  4. Peter Petros
    Pages 138-142
  5. Peter Petros
    Pages 176-190
  6. Peter Petros
    Pages 191-192
  7. Back Matter
    Pages 193-222

About this book


The initial objective of this work was to reduce stress incontinence surgery from a major surgical procedure (requiring up to ten days in hospital) to a minor day-care operation. From the beginning it was clear that the two major impediments to achieving this goal were post operative pain and urinary retention. Addressing these problems became a long and winding road and culminated in the Integral Theory. The IVS 'tension-free' tape operation was inspired by Dr Robert Zacharin's anatomical studies. Though Zacharin suggested that the ligaments and muscles around the urethra were important for urinary continence control, he did not say how. The observation that implanted foreign materials created scar tissue led to the hypothesis that a plastic tape inserted in the position of the pubourethrallig­ ament, would leave behind sufficient scar tissue to reinforce that ligament, which would then anchor the muscles for urethral closure. In September 1986, two prototype Intravaginal Sling operations were per­ formed. A Mersilene tape was inserted with neither tension nor elevation, in the position of the pubourethral ligament. Restoration of continence was immediate and both patients were discharged on the day following surgery without require­ ment for catheterization. There was minimal pain, and immediate restoration of continence. After six weeks the tapes were removed. Both patients were still conti­ nent at last review 10 years later. The results appeared to confirm the importance of a midurethral anchoring point.


Incontinence Integral Pelvic anatomy pain pelvic floor surgery

Authors and affiliations

  • Peter Petros
    • 1
  1. 1.Royal Perth Hospital and University of Western AustraliaPerthAustralia

Bibliographic information

  • DOI
  • Copyright Information Springer-Verlag Berlin Heidelberg 2004
  • Publisher Name Springer, Berlin, Heidelberg
  • eBook Packages Springer Book Archive
  • Print ISBN 978-3-662-05447-5
  • Online ISBN 978-3-662-05445-1
  • Buy this book on publisher's site